Employee Claim for Wage Restitution

Various contract related forms that will be included in the Homeland Security Acquisition Regulation

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1600-0002 can be found here:

Documents and Forms

Document Name Document Type
Form DHS 700-4 Employee Claim for Wage Restitution Form
DHS 700-4 Employee Claim for Wage Restitution DHS Form 700-4.pdf Form

Information Collection (IC) Details

IC Title:	Employee Claim for Wage Restitution	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	DHS 700-4	Employee Claim for Wage Restitution	DHS Form 700-4.pdf		Yes	No	Fillable Printable

Line of Business: Supply Chain Management

Subfunction: Services Acquisition

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 31	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	31	6	25
Annual IC Time Burden (Hours)	31	6	25
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.